In mail service pharmacies and large retail pharmacies, prescription drugs are dispensed in a high volume. For such services, it is known to use an automatic pill dispensing system to carry out the dispensing of the prescription drugs automatically at a rapid rate and to label pill containers which can then be provided to the patient for whom the prescriptions were written.
A known automatic pill dispensing system is described in U.S. Pat. No. 5,771,657 issued to Lasher et al., which is incorporated herein by reference. In the patent, as shown in the schematic illustration of FIG. 1A, orders (e.g., orders to fill prescriptions) are received by a host computer 9 which forwards the orders to a distributed computer system including a central computer called Pharmacy Automation Controller 10 (PAC). PAC 10 maintains an order file of the information about each prescription to be filled in an order including all of the information needed to fill each prescription, and prepares a prescription label for each prescription and the information to print literature to go in a shipping container with the prescription or prescriptions. PAC updates the order file to maintain a record of the current status of each prescription being filled as it progresses through the automated system.
PAC 10 controls a set of Print, Apply and Load (PAL) stations 14 which print prescription bottle labels, apply the prescriptions to prescription bottles, and load the labeled bottles onto bottle carriers that preferably receive the bottles in scheduled locations. PAC 10 also controls a carrier conveyer system 21 that carries the bottle carriers to different parts of the system, and one or more automatic drug dispensing machines 23 that dispense tablets and/or capsules into the prescription bottles in the bottle carriers as they are carried by the conveyer system 21. PAC 10 also controls bottle cappers 25 that apply caps to the bottles, and one or more OCP stations 29 that unload bottles from the carriers and place them in the shipping containers corresponding to the patient orders.
PAC 10 also controls literature printers 31 which print literature for each prescription order and enclose the literature for each prescription order in an envelope, print a bar code that shows through a window in the envelope identifying the prescription order, and then place each envelope on a literature conveyer 34 which carries the envelope from the literature printers 31 to the OCP stations 29.
The conveyer system 21 carries the bottles in the carriers from the PAL stations through the automatic drug dispensing machines 23 to the bottle cappers 25 and then from the bottle cappers to the OCP stations 29. The conveyer system 21 also carries the empty carriers back to the PAL stations 14. From the bottle cappers 25, the conveyers 56 feed the carriers onto an endless conveyer loop 71 which will transport the four carriers of a rank to one of six OCP stations 29.
The OCP stations each also have a literature dispensing mechanism, which inserts printed literature into each shipping container with the filled and capped prescription bottles.
As shown in FIG. 1B, bottles to be automatically filled with the prescription drugs are introduced to the automated system by hoppers 37, which receive the bottles in bulk form and automatically feed the bottles to unscramblers 39. One of the hoppers 37 and one of the unscramblers 39 will be for large bottles (e.g., 160 cc), and the remaining hoppers and unscramblers will be for small bottles (e.g., 110 cc). The small bottle size can preferably accommodate a majority of the automatically filled prescriptions. In the unscramblers, the bottles are singulated and oriented so that the bottle opening first faces downward. The bottles are then righted and directed to PAL stations 14 on bottle conveyers 41 and 43, one for large bottles and one for small bottles.
As shown in FIG. 1B, the conveyers 45, under control by PAC, carry the bottle carriers from the four PAL stations 14 to carrier buffers at the entrances of the four automatic drug dispensing machines 23 in which the tablets or capsules of the prescriptions are automatically dispensed into the prescription bottles under the control of PAC 10. Because of the organization provided by the carriers, the bottles are arranged into four columns approaching each automatic dispensing machine 23. Since there are four automatic dispensing machines 23, 16 parallel prescription bottle columns approach the dispensing machines. In the specific embodiment of the invention, the four automatic drug dispensing machines each have 384 drug dispensers arranged four columns wide and 96 rows deep to provide a total of 1,536 pill dispensers. The automatic drug dispensing machines are similar to those described in the U.S. Pat. No. 5,660,305, which is hereby incorporated by reference. Each dispensing lane is divided into 32 buffer assemblies each containing twelve drug dispensers oriented six on each side of a conveyer within the dispensing machine.
The carrier will be released by the PAL station 14 onto a conveyer 45 which carries the carrier loaded with the labeled empty prescription bottles to an automatic dispensing machine 23, of which there are four, one for each PAL station 14. When a carrier moves out of the last row position in a dispensing machine, all of the prescription bottles in that bottle carrier should be filled and a conveyer 56 transports the prescription bottles now filled with the prescriptions to a bottle capper 25.
The bottle quality assurance area 109 has several stations at which pharmacists will scan the bar code on the bottles and visually inspect the contents of the bottles. The scan of the bottle bar code will bring up a display on the pharmacist's terminal which includes all the information regarding the particular prescription and order including the drug name, and instructions which identify the reason for the verification. All of the bottles that pass this inspection are inserted by the pharmacist on a bottle stream conveyer 111 to send the inspected bottles to the BSP station 112. The conveyer 108 leads to a star wheel diverter mechanism 114 which under the control of a controller for the BSP station deposits the bottle in a bottle stream conveyer 116 leading to the bottle quality assurance area 109 or into a bottle stream conveyer 118 leading to BSP station 112.
If the literature pack is on the conveyer 34, but because of failure of the bar code reader (not shown) or the literature sorting mechanism, does not get diverted at station 112, the conveyer 34 will carry the literature package to the package quality assurance area where it can be manually added to the package. If, because of a malfunction, a literature envelope is not deflected by a deflector (not shown), because of, for example, an improper bar code on the envelope, the envelope will continue on the conveyer 34 to the end of the conveyer and be dumped into a receptacle at the package quality assurance station 96. If the bag does not contain a literature pack, then the bag is diverted into a tote (not shown) which will then be transported by a conveyer 101 to the package quality assurance station 96 where the shipping container will be assembled with the literature pack manually 137. FIG. 2 shows another known dispensing system as described in U.S. patent application Ser. No. 10/215,249, which is incorporated herein by reference. In particular, FIG. 2 shows a system 250 that can include a storage device for packages 203, dispenser for the packages 205, storage device for bottles filled with counted pills 209, dispenser for the bottled with counted pills 207, storage device for patient specific literatures 211, dispenser for the patient specific literatures 213, consolidation station 215, and host computer 201. System 250 can be referred to as a automated labeling and packaging system (ALPS).
The system shown in FIG. 2 can also include one or more local computers (not shown). For instance, each of the components (e.g., 203, 205, 209, 207, 211 and 213) can be connected to one or more local computers. The local computers in turn are connected to host computer 201. In this way, host computer 201 and local computers are configured to control the various components of the present invention.
A local computer can also function with a standard Programmable Logic Controller (PLC). A PLC typically includes an I/O card to turn on/off a device. Accordingly, when a component is to be controlled by turning it on/off, a PLC can be used. When a large quantity of data is to be exchanged, a local computer can be used.
Host computer 201 can receive a request to fill an order, optionally in combination with the local computer(s) and/or the various components. In response, host computer 201 creates an order number and determines whether the order contains an order that requires bottles to be filled by counting individual tablets and whether the order contains an order that requires packages from the storage device for bottles 209.
The storage device for packages 203 stores packages that contain pharmaceutical products. For example, one set of packages may contain a predetermined number of tablets (e.g., 500 tablets) of a certain drug (e.g., Allegra). Another set of example packages may include liquid pharmaceutical products. The packages can be made by original producers of drugs (e.g., Hoechst Marion Roussel). The packages can also be bulk bottles that are filled by any one of many automated (e.g., the ADDS) or manual methods known in the art. These packages can then be shelved so that their locations can be automatically identified. In turn, the dispenser for the packages 205 is configured to automatically identify the location of any package with a certain type of drug, dosage and/or quantity and configured to pick one or more packages from the identified location. In other words, a package contains a pharmaceutical product without having been pre-designated for any specific order when the package was created.
In operation, the command to locate and pick one or more packages is received from host computer 201. The dispenser for packages can also be connected to its own local computer to perform the necessary functions to locate and pick one or more packages in accordance with the command from host computer 201. It should be noted that the packages stored in the storage device for packages 203 are not designated for any specific patient. In other words, any package can be picked to fill an order of a patient as long as the type of drug, dosage and/or quantity are matched with the order.
FIG. 2 can also include a standard sensor or a standard counter to indicate when a specific type of package is out of stock in the storage device for packages 203. These sensors or counters can be present at each location (or a substantial number of them). The signals from the sensors or counters can be communicated to, for example, the host computer 201 via the local computer. In turn, the host computer 201 can notify an operator or system to replenish the specific packages and/or stop the process of filling orders that require the specific type of package that are out of stock in the storage device for packages 203. In addition, or optionally, host computer 201 can send a query to the storage device for packages 203 regarding whether a certain number of certain packages are available to be dispensed. In response, the storage device for packages 203, or in combination with its local computer, can send a response based on information from the sensors and/or counters. Alternatively, sensors may be placed on the robot arm or picking device to provide the similar functionality. In yet another alternative, sensors are not utilized and the system keeps logical control by knowing how many packages have been placed in a channel and how many packages have been removed from the channel.
The dispenser for bottles 207 is configured to receive bottles that contain specific number (e.g., 1-500 or more) of pills for a specific order. For example, one bottle may include 350 tablets of one type of drug for patient A, while another bottle may include 600 tablets of another type of drug for patient B. The bottles can be filled by any automatic dispensing mechanisms known in the art (e.g., the system shown in U.S. Pat. No. 5,771,657). Bottles can also be manually filled (by, e.g., a pharmacist).
If an automatic dispensing system is used, host computer 201 sends commands to fill bottles with certain number of pills for a certain type of drug. Once they are filled, the bottles are stored in the storage device for bottles 209. In a similar fashion, in a manual system, the dispensing person would receive an instruction to count certain number of tablets for a certain type of drug. The person fills bottles according to the instructions and forwards the bottles to the storage device for bottles 209.
Once the storage device for bottles 209 receives all the bottles necessary to fill an order, the storage device for bottles 209 or in connection with its local computer sends a message to the host computer 201 indicating that the bottle portion of the order has been filled. For example, an order to fill an order may require 1450 pills of a certain type of drug. In this example, the storage device for packages 203 may already have two packages each with 500 pills of the drug. If so, one bottle with 450 pills of the drug is necessary to fill the bottle portion of the order. (If one bottle cannot receive all 450 pills then more than one bottle would become necessary to provide the 450 pills).
The storage device for literature packs 211 contains literatures to be packaged with specific orders. For example, a set of literature packs for one order may include information relating to each of the prescribed drugs, how often each drug must be taken, billing information, special instructions from the prescribing doctor, insurance information, refilling information and/or general information, for example health or notification of other services. The set of literature packs is then packaged per order and collected in the storage device for literature packs 211. Once the necessary literature packs are created, the storage device for literature packs 211, or in combination with its local computer, can notify the host computer 201 that the literature pack has been printed.
Upon receiving various information from the storage device for packages 203, storage device for bottles 209 and storage device for literature packs 211, host computer 201 then sends instructions to the dispenser for the packages 205, dispenser for bottles 207 and dispenser for literature packs 213, or to their local computers, to dispense necessary bottle(s), package(s) and literature pack(s) to fill one or more orders. The dispensed bottle(s), package(s) and literature pack(s) are then consolidated by the consolidation station 215 and then sent, distributed or mailed out directly or indirectly to patients associated with the orders.
FIG. 3 shows yet another known system as disclosed in U.S. Pat. No. 5,208,762 to Charhut et al., which is incorporated herein by reference. As illustrated in FIG. 3, a system 310 is provided for dispensing prescriptions. The system 310 includes three lines 312, 314 and 316 of machines that can automatically fill, label, cap, and sort vials 318 in accordance with a patient's prescription order under the control of an appropriate control system.
For ease of understanding, only one of lines 312, 314, and 316 will be described in detail. However, with the exception of vial size, the description is applicable to each of lines 312, 314, and 316. Therefore, reference numerals identifying items in the drawings which have counterparts associated with each line will be used generically in this description, but in the drawings will carry additional designations such as a, b, and c to identify those items corresponding to the particular lines.
The first machine position at each line of the system is a vial unscrambler 320. In such a machine, vials of one size are dumped into a hopper 322 in bulk form.
The unscrambler 320 orients the vials upright in a separator 323 and spaces them on a conveyor 324 ready to feed into a vial filler 326. The unscrambler 320 can also be equipped to shoot a blast of air into the vial, cleaning debris that might be present.
From the unscrambler 320, a vial will travel via the conveyor 324 to the vial filler 326 (also referred to as the filler). The vial filler 326 preferably comprises a modified Automatic Tablet Control (ATC) machine. The ATC machine is capable of holding up to about 480 different oral, solid medications. Such medications are held in canisters calibrated specifically for those drugs. There can be one or more ATC machines per line depending on drug mix and drug volume required by the institution in which the system 310 is installed.
The conveyor 324 brings the vial under a filling position of the filler 326 and a signal from the controller system activates the appropriate drug canister, as required. More than one canister can be assigned to a specific drug and can dispense doses simultaneously. The drug doses are counted into the vial until filling is complete.
After filling, the vial is labeled by a label machine 328 (also referred to as the labeler). The labeler 328 can be located downstream of the vial filler 326 as shown or it can preferably be located under the vial filler 326 to label vials during or immediately following filling. A signal from the control system is sent to the label machine 328 at the same time the vial is being filled. The label machine print human readable information, as well as bar code information on demand. The label information is kept in a data base and contains drug description, as well as any warning statements.
After the label is printed, a reader can be provided associated with the labeler 328, to verify the contents of the label by reading the printed bar code. Once a vial is filled and labeled, it travels down the conveyor 324 to a capping machine 330 (also referred to as the capper). The capping machine 330 grasps the vial and preferably applies a child-resistant cap 331 to the vial.
Just after the capper 330, each line includes a bar code reader 336 and a wrap belt 339 disposed on opposite sides of the conveyor 324. The wrap belt 339 serves to spin a vial around so that the bar code thereon can be read by the reader 336. The bar code reader 336 verifies the legibility of the bar code on the label and confirms the prescription number to the control system.
After the vial is capped, a sensor associated therewith verifies that the cap has been properly applied. The capper 330 preferably includes a reservoir 333 that is sufficiently large to store one full shift's supply of caps.
Once a vial has been capped and the contents are verified by the capper sensor 336, it proceeds to an accumulator or accumulation station 332 positioned at the end of its respective conveyor 324. The accumulation station 332 serves two functions: sorting and ejecting. Vials are ejected when they have an improper drug count, unreadable labels, or improperly seated caps. A signal sent by the filler 326, labeler 328, or capper 330 causes a defective vial to be ejected into a reject bin 335 by a blast of pneumatic air gun 334 if any of the situations is detected. When a vial is ejected, the control system places a refill request with the filler 326 on a priority basis so that another attempt is made to complete the prescription order.
A circulating conveyor 342 (also referred to as a sorting conveyor) carries circulating bins 340 along a path that brings each of the bins under an accumulator 332 once per rotation. The bins 340 are bar coded and the control system assigns at least one circulating bin 340 per patient. If a particular patient has more vials than a single bin can hold, a second or third bin will also be assigned. A bin 340 will circulate on the conveyor 342 until a patient's total order has been collected. The bar code on the bin 340 will be read by bar code reader 363 prior to travel under the accumulators 332 and a signal will correctly time an accumulator 332 to discharge a specific patient's vial into the bin 340.
All properly bottled vials are assigned to a location on the accumulator 332 where they await a circulating bin 340 in which they are to be placed. These locations are also referred to as the staging output area. The accumulator 332 preferably has up to twenty locations for temporary vial storage.
The accumulators 332 are positioned above the conveyor 342 so that the vials awaiting on an accumulator can be placed into a passing bin 340. To this end, each accumulator 332 has associated therewith a pneumatic gripper 337 on a rodless cylinder for placing upon command, a vial into an accumulator position.
One or more of the bins is assigned to a patient by the control system. As the assigned circulating bin(s) 340 move(s) under the vial accumulator 332, the accumulator 332 drops the vials into the assigned bin(s). The drop of the vials is effectuated by means of a release door contained in the accumulator position on which the vials rest and which is activated by a solenoid controlled by the control system. Preferably, the accumulator 332 is capable of placing its entire contents in one bin, if necessary. In this manner, all of the vials for one patient's order can be sorted and placed together in a bin.
When a patient's total order has been accumulated in one or more bin(s) 340, the sorting conveyor 242 transfers the bin(s) 340 to one of a plurality of spurs.
Spur 350 is a conveyor referred to as the exception conveyor. An order is placed on spur 350 if, for some reason, the contents must be modified due to error. Spur 350 can also be used to place medications other than oral solids into a patient's bin 340. This spur 350 can carry a bin 340 under a rack that contains, for example, liquids or creams. By reading the bar code on the bin 340, the rack automatically would discharge the correct medication into the bin 340.
Spur 352 is a conveyor referred to as the mail order conveyor. An order is placed on spur 352 if it is to be mailed to a patient. Spur 354 is a conveyor referred to as the pick-up conveyor. An order is placed on spur 354 if it is to be picked up by a patient, e.g. a walk-in.
As illustrated, a variety of extractors are operatively positioned to move bins onto and off of the conveyors 342, 350, 352, 360, and 361. These extractions are generally designated by the numeral 362. Extractor 362a, upon command, diverts bins from conveyor 342 into conveyor 350. Extractor 362b, upon command, diverts bins from conveyor 342 onto conveyor 352. Extractor 362c, upon command, diverts bins from conveyor 342 onto conveyor 354. Extractor 362d, upon command, diverts returned bins from conveyor 361 onto conveyor 360. Extractor 362e, upon command, diverts returned bins from conveyor 360 onto conveyor 342. Additionally, a scanner 363 is provided that reads bar codes on returned bins.
An empty bin 340 is placed on return conveyor 360 or 361 which places it back on circulating conveyor 342. Return conveyor 360 is used to return bins used for mail orders, while return conveyor 361 is used to return bins used for pick-up orders. At the point of return, the bar code on the bin (340) will be read and noted in the control system as an available bin. If the bar code is unreadable, the bin 340 is automatically ejected from the system 310. The return is located just downstream from the take-off on the circulating bin conveyor 342 so the circulating conveyor 342 will always be full. Overhead transfer cylinders 364 are used to transfer bins 340 from one straight conveyor 342a to another straight conveyor 342b, which together form the circulating conveyor 342.
In the above described conventional systems, in order to automatically and/or manually dispense medications and/or pharmaceuticals, the system must obtain large numbers of medications and/or pharmaceuticals from a variety of manufacturers using a variety of different stored bottles and/or packaging. The conventional systems shown in FIGS. 1-3 do not utilize, contemplate or suggest the use of a system that can automate the process of emptying the contents of manufacturers' drug carrying containers into a receptacle having a larger capacity, thereby simplifying the number and types of bottles that must be used for dispending pharmaceuticals.